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Occupational exposure to HIV: response to a system failure
Author(s) -
Cooper Elizabeth E,
Blamey Stephen L
Publication year - 2003
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.2003.tb05477.x
Subject(s) - citation , human immunodeficiency virus (hiv) , medicine , library science , gerontology , family medicine , computer science
The Medical Journal of Australia ISSN: 0025-729X 4 August 2003 179 3 162-163 ©The Medical Journal of Australia 2003 www.mja.com.au Lessons From Practice THIS REPORT DOCUMENTS a multifactorial failure of the system of reporting and responding to occupational exposures, which led to a substantial delay in instituting prophylaxis for HIV exposure. About half the percutaneous sharps injuries sustained by healthcare workers in the United States go unreported.1 At our 621-bed institution, 66 needlestick injuries were reported in 2001–2002, translating to a rate of 10.6 per 100 beds per year. As data from the US Exposure Prevention Information Network suggest that hospital healthcare workers incur about 30 needlestick injuries per 100 beds p r year, our rate of 1 .6 prob bly reflects significant underreporting. Increased staff confidence in the quality and confidentiality of follow-up for occupational exposures may help increase reporting.3 The average risk of HIV transmission for healthcare workers after percutaneous exposure to HIV-infected blood is about 0.3%.4 However, post-exposure prophylaxis with zidovudine has been shown in a retrospective case–control study of healthcare personnel to reduce transmission by about 81%.4 The Department of Human Services (Victoria) recommended in 1997 that post-exposure prophylaxis be initiated promptly, preferably within 1–2 hours of exposure (based on 1996 recommendations from the US Centers for Disease Control and Prevention).5 The US Department of Health and Human Services recommends that employers protect healthcare workers from needlestick injuries by providing a safe working environment with effective programs and safer needle devices, notwithstanding additional costs. This includes a combination of prevention strategies for reducing needlestick injuries, and involving workers in the effort.6